State redirects $800M more to health care providers

BOSTON - The Baker administration will direct another $800 million to the Massachusetts health care industry, supplementing $840 million in previously announced assistance as the state works to bulk up its front line of defense against the forthcoming COVID-19 surge.

Despite the large total, Gov. Charlie Baker said Tuesday that he does not plan to file a supplemental budget to seek new appropriations for the funding injection and can cover the cost using "offsets, reductions in MassHealth and enhanced federal revenue."

State leaders have now directed more than $1.6 billion toward the health care system since March, which Baker said is critical to help providers simultaneously meet any new needs and weather a period of declining revenues as elective procedures and in-person office visits have largely ceased.

"It's basically a big investment in our health care system," Baker said at an afternoon press conference. "It's designed to make sure these folks are financially able to stand up all the things we need to stand up as part of the surge."

Half of the new pot of funding will be split between 28 safety-net and high-Medicaid-population hospitals, Baker said, which are most heavily involved in treating patients with COVID-19 and as a result face both increased costs and revenue losses. The plan will also increase rates paid to hospitals for COVID-19 care by 20 percent and 7.5 percent for all other hospital services.

About $300 million will go to other health care providers, including more than $50 million for community health centers and $30 million for personal care attendants. Another $80 million of the fund will be set aside for nursing facilities, some of which have units dedicated to coronavirus patient care.

Funding will be distributed to recipients over the next four months.

"Health care providers have stepped up in unprecedented ways the past few weeks while experiencing significant impact on their revenue and operations," said Health and Human Services Secretary Marylou Sudders.

Many health care services have been put on pause amid the outbreak to direct focus and resources toward the growing number of cases of the highly infectious coronavirus. On March 15, Department of Public Health Commissioner Monica Bharel ordered hospitals to cancel nonessential elective surgeries, which cut into a large source of revenue for many facilities.

The Massachusetts Health and Hospital Association estimated that hospitals across the state are losing $1 billion per month due to the pandemic as revenue has "evaporated."

While the lack of surgeries has cut into hospitals' checkbooks, it also helped the administration develop its new package of funding: Baker said "a pretty significant drop in payments made for those kinds of activities" left MassHealth with more money to distribute.

That funding, combined with a higher federal reimbursement rate under a recent stimulus bill, comprises "a big piece of how the math works," the governor said.

"We don't need a supplemental budget because we're basically moving money around that's already a part of the appropriations we're working with," Baker said.

Government and health care officials across the state are bracing for the COVID-19 curve to peak and for a rush of new cases to hit hospitals. Modeling that Baker unveiled last week suggested the surge could begin between April 10 and April 20, although that number is not firm.

As of Tuesday afternoon, 15,202 patients in Massachusetts tested positive for the virus and 356 deaths were linked to the outbreak. The single-day increase of 96 reported deaths is by far the largest yet, though public health officials noted that it also counts some deaths that occurred over the weekend but had not been previously reported.

Baker reiterated Tuesday that Massachusetts will need more ventilators to meet the needs of its residents. About 95 of the 100 the state received from the national stockpile have been distributed, and administration officials are still working to get the federal government to fulfill their full request for up to 1,700.

Baker participated in a call Monday with Vice President Mike Pence and other governors, and while he said little new information arose, he said there has been "a lot of traffic back and forth between the federal government and state government" about preparations.

The governor, like other state leaders around the country, has previously clashed with Washington over its response and argued that states have been handicapped by a competitive bidding process.

Baker said Massachusetts will "continue to advocate for additional ventilators because we believe we need them," and he floated the idea of states sharing their resources with one another based on varying outbreak conditions.

"The surge is not going to happen at the same time in all 50 states," he said. "It's probably going to happen in clumps."

A new program is in place to conduct rapid, on-site testing of vulnerable residents in nursing homes and rest homes. Over the past week, the National Guard has visited 80 facilities and conducted more than 1,300 tests, officials said.

Long-term care facilities, including nursing homes, appear particularly vulnerable to the coronavirus outbreak. Through Tuesday, the Department of Public Health confirmed 958 residents or employees across 129 facilities had contracted the illness.

Sudders said the administration is embarking on a "deeper dive" to compile more detailed data about deaths per capita and how nursing homes fit into regional clusters.

Meanwhile, on Tuesday, House leaders unveiled legislation (HHD 5016) that would require long-term care and elderly housing facilities to report daily updates on COVID-19 cases and fatalities and would require the DPH to publish that information once per week.

"As we confront this public health emergency, we need prompt information on how COVID-19 affects those in our long-term care facilities," House Speaker Robert DeLeo and Elder Affairs Committee Co-chair Rep. Ruth Balser said in a Tuesday afternoon joint statement. "While we seek to learn more from the Administration about its plans to ensure the residents and workforce have the necessary testing and personal protective equipment, this bill will ensure we are receiving reliable and timely information about these facilities and the impact the virus is having on their residents, often those most in need in our society."

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